Therapie最新文献

{"title":"Discordance between pain specialists and patients on the perception of dependence on pain medication: A multi-centre cross-sectional study","authors":"","doi":"10.1016/j.therap.2024.01.008","DOIUrl":"10.1016/j.therap.2024.01.008","url":null,"abstract":"<div><h3>Aim</h3><div>Patients with chronic non-cancer pain are referred to pain centres to improve their pain treatment. The discontinuation of pain medications in case of poor efficacy can be difficult to accept for patients, particularly opioid analgesics. Previous research has described that from the patients’ perspective, the psychological relief of a negative effect of chronic pain and withdrawal symptoms of prescription opioids represent drivers of persistent use and first stage of opioid use disorder, despite insufficient pain relief. There is no validated tool to investigate this psychological dependence. This study aimed to assess discordance between patients and pain specialists in their perception of dependence on pain medication and investigate associations with characteristics of patients, type of pain and iatrogenic pharmacodependence.</div></div><div><h3>Methods</h3><div>Self-administered questionnaires (patients and physicians) were administered in six pain centres in France. A question on perceived dependence on pain medications was addressed to the patient and the physician in a matched pair. Discordance between them was evaluated by the Cohen kappa coefficient. Demographics, pain, anxiety and depression, pain medication withdrawal symptoms, diverted use, and craving represented variables studied in a multivariate model as potentially associated with patient-physician discordance.</div></div><div><h3>Results</h3><div>According to the 212 pairs of completed questionnaires, a perceived dependence was reported by the majority of patients (65.6%) and physicians (68.4%). However, the concordance was fair (kappa<!--> <!-->=<!--> <!-->0.38; CI [95%]: 0.25–0.51). Almost all patients (89.3%) were treated with an opioid analgesic. A higher likelihood of discordance was observed when patients suffered from nociplastic pain (odds ratio [OR]: 2.72, 95% [CI]: 1.29–5.84).</div></div><div><h3>Conclusion</h3><div>Medical shared-decision for changing pain treatment could be improved by taking into account the perception of patient dependence on medications for pain relief and or psychoactive effects, particularly in nociplastic pain for which the treatment is challenging.</div></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 5","pages":"Pages 543-551"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kératodermie aquagénique palmaire secondaire au traitement d’une ostéite chronique par tédizolide : à propos d’un cas","authors":"","doi":"10.1016/j.therap.2024.03.003","DOIUrl":"10.1016/j.therap.2024.03.003","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 5","pages":"Pages 614-615"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does gene therapies clinical research in rare diseases reflects the competitivity of the country: Example of France","authors":"","doi":"10.1016/j.therap.2024.01.007","DOIUrl":"10.1016/j.therap.2024.01.007","url":null,"abstract":"<div><div><span>Rare diseases<span> are chronic, serious and generally genetic conditions affecting a small number of people, and their therapeutic management is a real challenge. They represent a considerable burden for patients, caregivers and society alike. Compared with existing symptomatic treatments<span>, gene therapies represent a promising new approach aimed at treating these diseases by replacing a defective gene, or by abolishing or reviving a gene-derived function. France is considered one of the leading countries in the research and development of drugs for rare diseases, yet the position of French public and private stakeholders in the research and development of gene therapies for rare diseases at global and European level remains unclear. To answer this question, we used the GENOTRIAL FR database developed by OrphanDev to clarify France's involvement and competitiveness in this field. The results show that France is actively involved in gene therapy clinical trials, with a dense international collaboration network and solid expertise. However, the French medical infrastructure is mainly involved in </span></span></span>clinical research on gene therapy candidates sponsored by several foreign countries. To a lesser extent, French public and private entities are also developing their own gene therapy candidates for various rare diseases, some of which have already reached advanced clinical phases. In conclusion, a number of technical and financial challenges need to be overcome if France is to maintain its position as a European and world leader and increase its contribution to reducing the economic and social burden of rare diseases by developing revolutionary and effective new therapies.</div></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 5","pages":"Pages 505-518"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139825933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmucosal fentanyl-related opioid use disorder in a cancer survivor","authors":"","doi":"10.1016/j.therap.2024.02.002","DOIUrl":"10.1016/j.therap.2024.02.002","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 5","pages":"Pages 609-611"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Use of a pharmaceutical decision support system in the valuation of hospital stays: Evaluation through 3 examples in collaboration with the department of medical information].","authors":"Laurine Robert, Ali Laraba, Amélie Bruandet, Alexandra Royer, Pascal Odou, Bertrand Décaudin, Chloé Rousselière","doi":"10.1016/j.therap.2024.07.004","DOIUrl":"https://doi.org/10.1016/j.therap.2024.07.004","url":null,"abstract":"<p><p>Pharmacy decision support systems (PDSS) help clinical pharmacists to prevent and detect adverse drug events. The coding of hospital stays by the department of medical information (DMI) requires expertise, as it determines hospital revenues and the epidemiological data transmitted via the French national hospital database. The aim was to study the interest and feasibility of using a PDSS, in collaboration with the DMI, to help with the coding of hospital stays. Over 5 months, three rules were implemented in the PDSS to detect gout, Parkinson's disease and oro-pharyngeal candidiasis. The PDSS alerts were analyzed by a pharmacy resident and then forwarded to the DMI, who analyzed the stays to see whether or not the coding for the disease corresponding to the alert was present. The absence of coding was evaluated and tracked, along with the resulting change in severity and valuation. Three hundred and ninety-nine alerts from the PDSS were analyzed and sent to the DMI, representing 211 stays and 309 uniform hospital standardized discharge abstract (UHSDA) in the fields of medicine, surgery and obstetrics. Two hundred and eight (67.3%) UHSDA did not have the coding corresponding to the alert. For the majority of these UHSDAs, apart from diagnostic precision, there was no impact on the valuation of stays. For 4 UHSDAs, the addition of the diagnosis code led to an increase in the value of the stay and the severity of the homogeneous patient groups. The total revaluation corresponding to this modification was €5416. The use of PDSS has helped in the precision of diagnosis coding and the valuation of stays. This result must be weighed against the time invested in analyzing alerts and associated coding. An improvement in disease detection and data processing is needed to be feasible in practice, given the more than 227,600 RSS performed per year at our facility.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of new drug releases on heart failure management and hospitalizations in France: A repeated cross-sectional study between 2014 and 2023.","authors":"Paul Gautier, Cécile Vindis, Meyer Elbaz, François Montastruc","doi":"10.1016/j.therap.2024.07.006","DOIUrl":"https://doi.org/10.1016/j.therap.2024.07.006","url":null,"abstract":"<p><p>Real-life data on the impact of sacubitril-valsartan and sodium-glucose cotransporter type 2 (SGLT-2) inhibitors on heart failure (HF) in France is lacking. Using French health insurance databases, we examined the ten-year evolution in HF medication use, focusing on SGLT-2 inhibitors and sacubitril/valsartan, and incidence of HF hospitalizations during the same period. We conducted a repeated cross-sectional study using medical-administrative data from French health insurance databases between 2014 and 2023. These included \"OpenMedic\" for outpatient medication reimbursements and \"ScanSanté\" for annual hospitalization data. Medications were classified using ATC codes, and hospitalizations were identified using ICD-10 codes. Statistical analyses encompassed annual rates of users and boxes dispensed for HF medications, along with HF, ischemic heart disease and ischemic stroke hospitalization rates. Prevalence of SGLT-2 inhibitors and sacubitril-valsartan use was also studied regionally, with direct standardization by age and sex, with the French population as the standard population. Between 2014 and 2023, HF drug use increased significantly, with beta-blockers and ACE inhibitors/ARBs leading in prevalence of use. ARNi and SGLT-2 inhibitors, introduced later, showed remarkable rises: +506% and +3766% in users since their market introduction, respectively. Meanwhile, HF hospitalizations slightly increased by +3.6% between 2016 and 2019, followed by a notable decline of -12.5% during 2019-2023, coinciding with the introduction of SGLT-2 inhibitors. In contrast, hospitalizations for ischemic heart disease rose by 11.6% over the period 2016-2019 and by +5.2% over the period 2019-2023, and hospitalizations for ischemic stroke rose by 8.2% over the period 2016-2019 and declined by -0.6% over the period 2019-2023. We observed regional disparities in SGLT-2 inhibitors use, with prevalence ranging from 0.9% in Bretagne to 1.5% in Hauts-de-France. The data suggests a temporal correlation between the increase in SGLT-2 inhibitors use and the decline in HF hospitalizations since 2019. More studies are needed to measure real life effectiveness of SGLT-2 inhibitors in heart failure.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure assessment of titanium dioxide via drugs available on the French market: A nationwide descriptive study.","authors":"Manon Cairat, Inge Huybrechts, Agnès Fournier","doi":"10.1016/j.therap.2024.07.005","DOIUrl":"https://doi.org/10.1016/j.therap.2024.07.005","url":null,"abstract":"<p><strong>Purpose: </strong>Based on potential adverse health effects including genotoxicity concerns, the European Union banned titanium dioxide (TiO₂) as a food additive in 2022, but food-grade TiO₂ can still be used in pharmaceutical products.</p><p><strong>Methods: </strong>This study described the presence of TiO₂ in drugs available on the French market and estimated the population exposure to TiO₂ through drug consumption. We used annual drug claim data aggregated at the national level together with data on the TiO₂ content of pharmaceutical products available on the French market in 2001-2020.</p><p><strong>Results: </strong>Of the 17 171 pharmaceutical specialties identified on the French market between 2001 and 2020, 38% contained TiO₂. That figure reached 95% for capsules, 92% for film-coated tablets, 74% for coated tablets and 66% for soft capsules. Only 1% of non-oral specialties contained TiO₂. The median TiO₂ amount in one common dispensing unit was 1.5mg for oral specialties containing TiO₂. We estimated that the mean exposure to TiO₂ per inhabitant through the consumption of reimbursed drugs between 2012 and 2020 was 1.71mg per day, with women (1.81mg/d) slightly more exposed than men (1.54mg/d) and people older than 59 years (4.00mg/d) much more exposed than younger people (1.24 and 0.21mg/d for 20-59 and<20 years old individuals, respectively).</p><p><strong>Conclusion: </strong>This study highlights a widespread presence of TiO₂ in drugs on the French market. The health impact of exposure to TiO₂ through drug consumption should be evaluated in future epidemiological studies.</p>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report of a slow-metabolism of CYP2D6 which led to a misuse of codeine: How can we detect it and how can we take care?","authors":"Deborah Montmeat, Xavier Declèves, Laurence Labat, Alicja Puszkiel, Serge Perrot, Anne-Priscille Trouvin","doi":"10.1016/j.therap.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.therap.2024.07.002","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survenue d’une pancréatite aiguë chez une femme traitée par dronabinol : retour sur un cas","authors":"","doi":"10.1016/j.therap.2023.09.004","DOIUrl":"10.1016/j.therap.2023.09.004","url":null,"abstract":"","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 4","pages":"Pages 489-491"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41213868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mésusage du paracétamol en soins primaires : étude transversale dans un contexte rural français","authors":"","doi":"10.1016/j.therap.2023.11.005","DOIUrl":"10.1016/j.therap.2023.11.005","url":null,"abstract":"<div><h3>Objectifs</h3><p>Estimer la prévalence de l’usage de paracétamol pour une autre raison que la douleur (mésusage qualitatif) au cours des 12 derniers mois parmi des patients suivis en médecine générale ainsi que les raisons de ce mésusage.</p></div><div><h3>Méthodes</h3><p>Analyse transversale descriptive avec redressement sur le sexe de l’échantillon pour estimer la prévalence du mésusage de paracétamol.</p></div><div><h3>Résultats</h3><p>Au total les données de 209 patients ont été retenues dans l’analyse. Parmi eux, 11 patients déclaraient avoir pris du paracétamol pour une raison que la douleur, soit une prévalence pondérée sur le sexe de 5,7 % (IC95 % : 3,0 à 10,4). Près de deux tiers de ces patients déclaraient l’avoir fait pour se sentir mieux.</p></div><div><h3>Conclusions</h3><p>Le mésusage de paracétamol est peu fréquent mais bien réel en médecine générale. Des études complémentaires sont nécessaires pour mieux le comprendre, en particulier des études qualitatives.</p></div><div><h3>Objective</h3><p>To estimate the prevalence of the paracetamol use for a reason other than pain (qualitative misuse) during the last 12 months in patients consulting their general practitioner, as well as the reasons for this misuse.</p></div><div><h3>Methods</h3><p>Descriptive cross-sectional analysis, with gender weighting to estimate the prevalence of paracetamol misuse.</p></div><div><h3>Results</h3><p>In total, data from 209 patients were included in the analysis. Among them, 11 patients declared having taken paracetamol for a reason other than pain, i.e., a gender-weighted prevalence of 5.7% (95% CI: 3.0 to 10.4). Nearly two-thirds of these patients said they had done it to feel better.</p></div><div><h3>Conclusions</h3><p>The paracetamol misuse is rare but real in general practice. Further studies are needed to better understand it, especially qualitative studies.</p></div>","PeriodicalId":23147,"journal":{"name":"Therapie","volume":"79 4","pages":"Pages 429-433"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139298608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}